Systemic lupus erythematosus and antiphospholipid syndrome related retinal vasculitis mimicking ocular cysticercosis: a case report.

Making accurate and timely diagnosis is often challenging when patients with a systemic disease first present with ocular manifestations. The possibility that vasculitis associated with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) can be misdiagnosed as cysticercosis has not been discussed in the literatures.

[Factors associated with visual prognosis of acute retinal necrosis syndrome].

OBJECTIVE: To investigate relevant factors affecting the prognosis of acute retinal necrosis syndrome (ARN). METHODS: Case-series study. The clinical data of 41 patients (53 eyes) with ARN were retrospectively analyzed. Eyes were divided into two groups according to best corrected visual acuity at final visit. The groups were best corrected visual acuity better than 0.1 (group A, 28 eyes) and worse than 0.1 (group B, 25 eyes). Data were analyzed using the χ(2) test, Fisher exact test, Mann-Whitney test, bivariate correlation statistics, and multinomial logistic regression analysis. RESULTS: All patients were treated with systemic antivirus drugs and glucocorticoid. Ten eyes were treated with prophylactic laser retinopexy, 26 eyes underwent intravitreal ganciclovir, and 31 eyes underwent vitrectomy. All contralateral eyes of unilateral ARN patients were not involved after systemic antivirus treatment. Compared to group B (16.0%, 4/25), more eyes with best corrected visual acuity better than 0.1 at first visit were observed in group A (85.7%, 24/28) (χ(2) = 23.037, P = 0.000). Duration from onset of symptoms until first administration of antivirus drugs was shorter in group A [(15 ± 13) days] than in group B [(30 ± 34) days, Z = -2.414, P = 0.016]. Compared to group A (25.0%, 7/28; 10.7%, 3/28; 7.1%, 2/28; 39.3%, 11/28), more eyes in group B suffered from retinal detachment (80.0%, 20/25), occlusive central retinal vasculopathy (56.0%, 14/25), optic atrophy (36.0%, 9/25) and proliferative vitreoretinopathy (92.0%, 23/25) (χ(2) = 13.862, 10.440, 5.048, 13.749; P = 0.000, 0.001, 0.025, 0.000). Logistics regression analysis showed that visual prognosis were related to factors including best corrected visual acuity better at first visit (OR = 27.225, P = 0.003) and occlusive central retinal vasculopathy (OR = 0.065, P = 0.053). No difference in the number of eyes with increased intraocular pressure was observed between group A and group B (P > 0.05). Prophylactic laser retinopexy before retinal detachment and intravitreal ganciclovir were not associated with visual prognosis (P > 0.05). CONCLUSION: Worse visual acuity at first visit and occlusive central retinal vasculopathy are major relevant factors threatening visual prognosis.

Spectral domain optical coherence tomography of Vogt-Koyanagi-Harada disease: novel findings and new insights into the pathogenesis.

OBJECTIVE: To provide novel spectral domain optical coherence tomography (SD OCT) findings of Vogt-Koyanagi-Harada (VKH) disease as well as new insights into the pathogenesis of this disease. METHODS: Detailed SD OCT and fluorescein angiography (FA) findings of 18 consecutive VKH patients (11 women and 7 men) from December 2007 to April 2009 who were in acute uveitic stage at presentation were reviewed. All the patients had been followed up for at least 6 months with reevaluation(s) of SD OCT performed in 10 patients. RESULTS: Intraretinal cysts were found to be located in various layers of the outer retina. In addition to the photoreceptor layer, they could also be found between the outer plexiform layer and the outer nuclear layer, or spanning the external limiting membrane. On FA, intraretinal cysts could be hypofluorescent, normofluorescent, or hyperfluorescent. Some intraretinal cysts had a characteristic FA pattern, in which a small round hypofluorescent area was surrounded by a ring of hyperfluorescence (donut-shaped dye pooling). Subretinal fibrinoid deposit appeared in acute uveitic stage in two severe VKH patients and seemed to develop from subretinal exudates and evolved into typical subretinal fibrosis. Gradual transfiguration/migration and progressive proliferation/pigmentation of the subretinal fibrinoid deposit/subretinal fibrosis was observed in one patient. CONCLUSIONS: Intraretinal cysts could form in various layers of the outer retina and may result from extension of choroidal inflammation. Subretinal fibrosis may develop from subretinal exudates in VKH patients and may cause substantial visual impairment.

[Ocular features of multiple endocrine neoplasia type 2b].

OBJECTIVE: To analyze the ocular features of multiple endocrine neoplasia type 2b (MEN 2b). METHODS: Three cases with MEN 2b were reviewed and their ocular features analyzed. RESULTS: All patients had medullary thyroid carcinoma and thickened corneal nerve fibers. Adrenal pheochromocytoma, oral mucosal neuroma, marfanoid body habitus, eyelid nodule and conjunctival nodule were found in two patients. And iris nodule was found in one patient. CONCLUSIONS: The most common ocular manifestations of MEN 2b is thickened corneal nerve fibers.

[Progress in the studies of molecular genetics in Bietti crystalline corneoretinal dystrophy].

CYP4V2, a relatively new member of human cytochrome P450 (P450) enzymes, is termed an "orphan" P450 because its substrate specificity and physiological roles are unknown. Mutations in the CYP4V2 gene is associated with an autosomal recessive inherited ocular disease named Bietti's crystalline dystrophy (BCD). The strong gene-disease associations provide unique opportunities for elucidating the substrate specificity of this orphan P450s and unraveling the biochemical pathways that may be impacted in patients with CYP4V2 functional deficits.

[Choroidal thickness in normal subjects measured by enhanced depth imaging optical coherence tomography].

OBJECTIVE: To evaluate the efficiency of enhanced depth imaging optical coherence tomography (EDI-OCT) on quantifying choroidal thickness (CT) in normal subjects. METHODS: This was a cross-sectional study. From June to November 2011, 129 eyes of 129 normal subjects were enrolled in this study and divided into three groups by age distribution. Group A, 43 eyes, 22 to 40 years old; group B, 42 eyes, 41 to 60 years old and group C, 44 eyes, 61 to 79 years old. They were examined with EDI-OCT for CT. The choroid was measured from the posterior edge of the retinal pigment epithelium to the choroid-scleral junction at 500 µm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. The paired t test was used to analyze differences in CT by location in the macula. One-way analysis of variance (ANOVA) was conducted to compare mean CT in different groups. Subsequently the data between two groups were analyzed by least significant difference (LSD-t). The reliability was evaluated by intraclass correlation coefficient (ICC). RESULTS: The choroid was thickest beneath the fovea (305.9 ± 78.2) µm. The mean CT decreased rapidly in the nasal direction and gradually in the temporal direction, reaching (159.0 ± 67.3) µm at 3 mm nasal to the fovea and (256.8 ± 73.6) µm at 3 mm temporal to the fovea. There was a significant difference between subfoveal CT and CT at all extrafoveal locations (t = 4.021 to 34.544, P < 0.05). There was also a significant difference of CT at all locations among three age groups (F = 34.122 to 72.239, P < 0.05). CT was significantly greater in group A than group B and C at all locations (P = 0.000, 0.000). It was also significantly greater in group B than group C (P = 0.000). The inter-examination ICC values ranged from 0.979 to 0.996. The intraobserver ICC values ranged from 0.981 to 0.997. The interobserver ICC values ranged from 0.971 to 0.995. CONCLUSIONS: Normal CT can be measured accurately by EDI-OCT. There are significant differences of CT between different age groups in normal subjects.

[Promoting effects of CYR61 on proliferation, migration and tube formation of choroid-retinal endothelial cells].

OBJECTIVE: To observe the effects of CYR61 (cysteine-rich 61; CCN1) on the proliferation, migration and tube formation of choroid-retinal endothelial cells (RF-6A cell line). METHODS: Experimental study. RF-6A cells were cultured and treated with CYR61 at different concentrations. Effects of CYR61 on cell proliferation, migration and angiogenesis were observed by MTT assay, transwell assay and tube formation assay. RESULTS: When different concentrations of CYR61 (0, 5, 10, 100 and 500 µg/L) were used to treat RF-6A cells for 72 h, A(490) nm value of the MTT assay was changed dose-dependently (0.511, 0.522, 0.532, 0.597, 0.765 and 0.818), and the difference between different dosage groups was statistically significant (F = 318.828, P < 0.05). When RF-6A cells were treated with 400 µg/L CYR61 for different time periods (0, 12, 24, 48 and 72 h), A(490) nm value increased with the extension of treatment time (0.533, 0.598, 0.643, 0.695 and 0.756), and the difference was statistically significant (F = 42.910, P < 0.05). In transwell assay, migrated cells in cells treated with different concentrations of CYR61 (40, 200, 400 µg/L and 400 µg/L + 25 mg/Lanti-CYR61 antibody), 80 µg/L VEGF, and negative control groups were 66.83 ± 3.87, 77.83 ± 4.26, 96.83 ± 3.49, 70.67 ± 3.83, 98.33 ± 3.14 and 62.00 ± 7.62 per high-power field, respectively. RF-6A cell migration capacity increased with increased concentration of CYR61 (F = 46.987, P < 0.05). In tube formation assay, numbers of tube in different concentrations of CYR61 (40, 200, 400 µg/L, 400 µg/L + 25 mg/L anti-CYR61 antibody), 80 µg/L VEGF and negative control groups were 34.33 ± 2.50, 60.67 ± 3.72, 88.17 ± 2.93, 51.17 ± 2.14, 90.83 ± 3.49 and 31.83 ± 3.31 per field. RF-6A cell tube formation capacity increased with increased concentration of CYR61 (F = 355.224, P < 0.05). There were equal effects between 400 µg/L CYR61 and 80 µg/L VEGF. Anti-CYR61 antibody could inhibit cell migration and tube formation promoted by CYR61. CONCLUSIONS: CYR61 can promote proliferation, migration and tube formation of choroid-retinal endothelial cells in vitro. CYR61 are likely to be involved in the pathogenesis of retinal neovascularization.

[Changes of photoreceptor layer on spectral domain optical coherence tomography in idiopathic macular hole after vitreous surgery combined with air tamponade].

OBJECTIVE: To evaluate the tamponade effect of sterilized air in vitrectomy for idiopathic macular hole (IMH) as well as changes of photoreceptor layer after surgery. METHODS: Forty-five eyes of 45 consecutive cases underwent vitrectomy and air tamponade. Surgical outcomes were retrospectively analyzed, consisting of logarithm of the minimal angle of resolution (logMAR) and SD-OCT findings including the size of IMH and the photoreceptor layer defect. RESULTS: Preoperatively, mean BCVA was 0.08 (range, 0.4 to HM), mean hole diameter was 827.4 µm (range, 204 to 1616 µm), and mean diameter of photoreceptor layer defect was 1988.9 µm (range, 792 to 3444 µm). The primary closure rate was 75.6%. One month after surgery, mean BCVA was 0.13 (range, 0.5 to LP), and mean diameter of photoreceptor layer defect was 1285.1 µm (range, 166 to 2553 µm), both presenting a significant decrease. Preoperative hole diameter and postoperative diameter of photoreceptor layer defect were statistically significantly correlated with postoperative BCVA (r = 0.526, 0.628; P < 0.05). CONCLUSIONS: Vitrectomy plus air tamponade is safe and effective for the treatment of IMH, and the time for face-down positioning is obviously shortened. Preoperative hole diameter and postoperative diameter of photoreceptor layer defect are major predictive factors of visual acuity.

[Analysis of fundus fluorescein angiography, indocyanine green angiography and choroidal thickness in central serous chorioretinopathy].

OBJECTIVE: To evaluate the characteristics of choroidal thickness changes and abnormalities in choroidal circulation in cases of central serous chorioretinopathy (CSC). METHODS: This was a case control study, we measured the bilateral choroidal thickness in 21 patients with unilateral CSC and 24 eyes of 24 age- and sex-matched normal subjects using enhanced depth imaging optical coherence tomography (EDI-OCT). The choroid was measured from the posterior edge of the retinal pigment epithelium (RPE) to the choroid-scleral junction at 500 µm intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Paired-samples t-test was conducted to compare mean choroidal thicknesses between symptomatic eyes and fellow eyes of patients. The datum between patients and normal subjects were analyzed by independent-samples t-test. Fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed and the digital images were analyzed in CSC patients. RESULTS: The 21 CSC patients had a mean age of 45.6 years, and 12 patients (57.1%) were male. The choroid in symptomatic eyes was thickest beneath the fovea (519.0 ± 102.5) µm. It was significantly thicker than that in the fellow eyes (439.3 ± 94.1) µm (t = 4.171, P < 0.05). Choroidal thickness in both groups was significantly greater than that in the eyes of age- and sex-matched normal subjects (332.0 ± 67.3) µm (t = 7.125, 4.441; P < 0.05). Choroidal thickness at each of the other 12 points showed a similar tendency (t = 2.544 to 3.819, 4.799 to 7.816, 2.487 to 5.236; P < 0.05). ICGA showed a choroidal filling delay (100%), vessels dilation (90.5%), and focal choroidal hyperfluorescence (100%) surrounding leakage from the RPE in symptomatic eyes. Pigment epithelium detachment with abnormal choroidal circulation was observed in 6 fellow eyes. In 4 symptomatic eyes and 11 fellow eyes, ICGA revealed choroidal hyperfluorescence but FFA showed normal appearance. CONCLUSIONS: CSC seems to be a bilateral eye disease with choroidal focal ischemia followed by vessels congestion and hyperpermeability. EDI OCT is a useful tool for monitoring choroidal thickness changes caused by choroidal vascular hyperpermeability.

Factors related to prognosis of refractory glaucoma with diode laser transscleral cyclophotocoagulation treatment.

OBJECTIVE: To evaluate the predictive factors of refractory glaucoma treated with diode laser transscleral cyclophotocoagulation (TSCP) in a midterm observation. METHODS: Fifty-four consecutive patients (54 eyes) with refractory glaucoma were enrolled and underwent TSCP (power of 1.5-2.0 W, exposure time of 2 seconds and 20-50 applications). Patients were regularly followed up for 12 months. Intraocular pressure (IOP) was measured before TSCP treatment and at each follow-up visit. Patients were divided into the sensitive and insensitive groups according to the effect of a single treatment of TSCP on IOP. The success rate was defined as the percentage of eyes achieving an IOP between 5 and 21 mm Hg following TSCP therapy at their final follow up visit. Difference of age between the sensitive and insensitive groups was evaluated with independent-samples T test and that of gender distribution of two groups was evaluated with Fisher's exact test. The success rate of different types of glaucoma to TSCP was calculated. RESULTS: A total of 32 patients were sensitive to TSCP (sensitive group) and 22 patients were insensitive to TSCP (insensitive group). The success rates of female (77.8%, 14/18) and cases being over 50 years (71.4%, 20/28) were higher than those of male (50.0%, 18/36) and ones being under 50 years (46.2%, 12/26) (all P>0.05). The age of the sensitive and insensitive groups was 56.0+/-15.5 and 46.4+/-15.4 years, respectively (P=0.029). The age (P=0.029) and gender distribution (P=0.046) of the two groups had significant difference. The success rate of neovascular glaucoma, primary angle-closure glaucoma, primary open angle glaucoma, traumatic glaucoma, uveitic glaucoma, and secondary glaucoma after silicone oil injection to TSCP was 57.1%, 100.0%, 50.0%, 20.0%, 81.8%, and 0%, respectively. CONCLUSION: Age, gender, and type of glaucoma appear to be associated with effect of TSCP on IOP control.

[Prevalence and risk factors of retinal arterial atherosclerosis in urban subjects participating in routine physical examinations].

OBJECTIVE: To determine the prevalence and risk factors of atherosclerotic lesions in retinal arteries of an urban population undergoing routine physical examinations. METHODS: Demographic and clinical information of subjects participating in annual routine physical examinations at Peking Union Medical Center from January to October of 2010 were collected and summarized. Univariate and multivariate Logistic regression analyses were conducted to evaluate the demographic and clinical factors associated with retinal arterial atherosclerosis. RESULTS: Among a total of 17 886 non-diabetic adults evaluated during the study period, retinal arterial atherosclerosis was diagnosed in 1721 (9.6%). There were predominantly grade 1 (88%) and grade 2 (11%) lesions. Prevalence of retinal arterial atherosclerosis increased with age. And traditional risk factors for cardiovascular diseases included overweight or obesity, hypertension, dyslipidemia and elevated fasting serum glucose. In a multivariate Logistic regression model, advanced age, male gender, obesity or overweight, hypertension and dyslipidemia were independently associated with a higher risk of retinal arterial atherosclerosis. Hypertension was prevalent in subjects above 40 years old while overweight or obesity had a high prevalence in all age groups. CONCLUSION: Retinal arterial atherosclerosis is common in this urban population. And aging, overweight/obesity and hypertension are the dominant risk factors. Routine physical examination is valuable for both the prevention and an early diagnosis of this disease.

[Correlation between retinal artery atherosclerosis and renal dysfunction in non-diabetic urban subjects aged over 40 during routine physical examinations].

OBJECTIVE: To evaluate the correlation between retinal artery atherosclerosis and renal dysfunction and compare their risk factors in an urban population of Beijing. METHODS: The non-diabetic adults > 40 years old undergoing annual physical examinations during June 2010 and February 2011 at one medical center were evaluated. Pearson correlation coefficient was calculated between retinal artery atherosclerosis and renal dysfunction. The analyses of multivariate Logistic regression were performed to compare the risk factors of these two diseases. RESULTS: Among 10 191 subjects included, retinal artery atherosclerosis was diagnosed in 1287 (12.6%) and renal dysfunction in 434 (4.3%). And 1.0% of subjects had both two diseases versus 12.2% with retinal artery atherosclerosis alone and 3.3% with renal dysfunction alone. Correlation coefficient was low between two diseases (r = 0.21; P < 0.01). According to the analyses of multivariate Logistic regression, the strongest predictors of retinal artery atherosclerosis were obesity (OR = 2.5, 95%CI 2.0 - 3.2) and hypertension (OR = 2.2, 95%CI 2.0 - 2.6) while advanced age (OR = 3.1, 95%CI 2.8 - 3.5 per 10 year increment) was the strongest factor for renal dysfunction. CONCLUSION: The low-level correlation and different risk factor profiles between retinal artery atherosclerosis and renal dysfunction indicate different pathogenic mechanisms of two diseases and suggest different preventive strategies.

[The development in the studies of AAV-mediated gene therapy in retina].

Significant progress in understanding the molecular basis of retinal disorders has led to the development of gene therapies for treatment of these diseases. Adeno-associated virus (AAV) is a useful vector for the treatment of retinal diseases due to its low toxicity and immunogenicity, ability to transducer both dividing and non-dividing cells, and stable transgene expression. A variety of animal studies and clinical trials have proved the safety and effectivity of retinal AAV-mediated gene therapy. AAV-mediated gene therapy, such as anti-angiogenic proteins, neurotrophic factors, anti-apoptosis factors were studied in animal disease models, and the results were satisfactory. However, the main drawback of AAV vectors is its relatively small packaging capacity, which needs further improvement.

[Recovery of photoreceptor inner/outer segment junction in spectral domain optical coherence tomography after surgery in idiopathic macular hole].

OBJECTIVE: To evaluate the findings of spectral domain optical coherence tomography (SD-OCT) in patients with idiopathic macular hole (IMH). METHODS: It was a retrospective case series study. Pre- and post-operative data from patients with IMH during 14 months were analyzed retrospectively. The main outcome data included logarithm of the minimal angle of resolution (logMAR) and SD-OCT findings, including the size of the IMH and the disruption of the boundary line between inner segments (IS) and outer segments (OS) of the photoreceptors. The data were analyzed using the statistical software SPSS14.0. The correlation among various data was analyzed by Bivariate correlation. The pre-and post-operative data were compared by paired-samples t-tests. RESULTS: Thirty two eyes of 32 patients were studied. The mean logMAR was 1.16 ± 0.46 (ranged from 0.40 to 2.00), the mean diameter of macular hole was (859.7 ± 292.0) µm (ranged from 332 to 1568 µm). The mean diameter of IS/OS disruption was (1965.1 ± 584.1) µm (ranged from 867 to 3444 µm). In eyes after surgery, the mean logMAR was 0.89 ± 0.46 (ranged from 0.30 to 2.00), the mean diameter of the IS/OS disruption was (1350.4 ± 642.6) µm (ranged from 153 to 2546 µm), both were decreased significantly as compare with the preoperative data (t = 3.384, 6.360; P < 0.05). Preoperative diameter of macular hole (r = 0.583) and IS/OS disruption (r = 0.416) were correlated significantly with postoperative logMAR (P < 0.05). CONCLUSIONS: Preoperative diameter of macular hole and IS/OS disruption play the main role in vision prognosis. The IS/OS disruption is decreased significantly after the operation.

[Tomographic features of polypoidal choroidal vasculopathy lesions by spectral domain optical coherence tomography].

OBJECTIVE: To analyze the tomographic features of branching vascular networks and polypoidal lesions in patients with polypoidal choroidal vasculopathy (PCV) by spectral domain optical coherence tomography (SD-OCT). METHODS: It was a retrospective case series study. Retrospective review of 63 eyes of 54 patients with PCV identified with indocyanine green angiography (ICGA). Tomographic features of branching vascular networks and polypoidal lesions on SD OCT, ICGA and fluorescein angiography were analyzed. RESULTS: Both branching vascular network and polypoidal lesions were found in 45 eyes on ICGA, branching vascular network only was found in 8 eyes and polypoidal lesions only in 10 eyes. Retinal pigment epithelial detachment (RPED) was found in all 53 eyes with branching vascular networks on SDOCT. Thirty-eight eyes had areas of moderate reflectivity of branching vascular network between the fluctuating retinal pigment epithelium and Bruch membrane. Fifteen eyes had moderate reflectivity of branching vascular network and/or hemorrhage between high doom-like RPED and incomplete Bruch membrane. Solitary polypoidal lesions in 28 patients showed local moderate reflectivity between the RPE and Bruch membrane on SDOCT. Other aggregate polypoidal lesions in 27 patients showed moderate reflectivity between high doom-like RPED and incomplete Bruch membrane. CONCLUSION: The vascular abnormalities of PCV identified with ICGA were visualized on SD-OCT images as areas of moderate reflectivity between RPE and Bruch membrane.

[Relationship between central visual acuity and retinal volume of macular fovea accessed by spectral domain optical coherence tomography in Stargardt disease].

OBJECTIVE: To assess the relationship between central visual acuity and retinal volume of macular fovea in patients with Stargardt disease by spectral-domain optical coherence tomography (SD OCT). METHODS: It was a retrospective case series study. Twenty eyes of 10 patients with Stargardt disease were investigated by three-dimensional spectral-domain optical coherence tomography. SD OCT images were obtained and retrospectively analyzed. The retinal volumes of macular fovea were measured by SD OCT, whose diameters were set as 3 mm and 1 mm separately (volume 3 and volume 1). The retinal thickness of macular fovea (macular thickness) and the width of IS/OS conjunction loss of macular fovea (IS/OS loss) were also measured by SD OCT. We correlated the logMAR BCVA with IS/OS loss, macular thickness, volume 3 and volume 1 by linear regression analysis. RESULTS: LogMAR BCVA was from 0.3 to 1.22. IS/OS loss was from 847 µm to 5306 µm. Macular thickness was from 20 µm to 126 µm. Volume 3 and volume 1 was from 1.06 to 1.76 mm(3) and 0.06 to 0.13 mm(3). LogMAR BCVA correlated with the IS/OS loss (r = 0.695, P < 0.05), macular thickness (r = -0.601, P < 0.05), and volume 3(r = -0.725, P < 0.05). LogMAR BCVA did not correlate with volume 1(r = -0.364, P > 0.05). CONCLUSIONS: SD OCT could demonstrate the retinal structure of Stargardt disease clearly. The retinal volume of macular fovea accessed by SD OCT correlated with the visual acuity of Stargardt disease.

[Application of Octopus 101 automated perimetry with kinetic and static program in patients with the anterior ischemic optic neuropathy].

OBJECTIVE: To investigate the clinical significance of the Octopus 101 kinetic and Static combined automatic perimetry in Anterior Ischemic Optic Neuropathy (AION). To assess the merit and demerit of Octopus 101 kinetic and static combined automatic perimetry performed in AION cases. METHODS: 45 AION patients were detected with Octopus 101 with kinetic and static 30 degrees, 60 degrees scope static program from June 2006 to September 2008. The mean defect (MD), loss variance (LV), areas of isopter, and reaction time were analyzed. The correlation between MD, areas of isopter and reaction time were analyzed. RESULTS: In AION, there are kinds of visual field defect related to the optic lesions in static perimetry examine. Kinetic programme display the isopter deletion. Isopter areas using I-2e and III-4e stimulus are significantly different (P < 0.05). Smaller stimulus can find more periphery changes in AION. CONCLUSIONS: The Octopus 101 perimeter can provide static and kinetic program in the same sitting. In clinical practice it is necessary to perform both static and kinetic examination in patients with AION because the visual field defects are diverse, and the data provided by static and kinetic program are complementary.

[Correlation between photoreceptor layer and visual acuity in eyes with persistent cystoid macular edema secondary to branch retinal vein occlusion].

OBJECTIVE: To study the correlation of visual acuity and photoreceptor in eyes with persistent cystoid macular edema associated with branch retinal vein occlusion (BRVO). METHODS: It was a retrospective case series study.Medical records of 41 patients (41 eyes) with persistent cystoid macular edema secondary to BRVO diagnosed in Department of Ophthalmology, Peking Union Medical College Hospital from January 2008 to January 2010 were studied retrospectively. On the images obtained by spectral-domain OCT, the thickness of foveal neurosensory retina and photoreceptor layer that was beneath the foveal cystoid spaces, and the transverse length and height of foveal cystoid spaces were measured. The status of the junction between inner and outer segments of the photoreceptors (IS-OS) in the fovea was also assessed. The correlations between the parameters above and visual acuity were analyzed. RESULTS: The average foveal neurosensory thickness was (484.71 ± 131.86) µm, the photoreceptor layer thickness was (92.04 ± 45.53) µm and the size of foveal cavity was 772.59 µm × 362.17 µm. By the Spearman's rank correlation analysis, among the parameters above, only photoreceptor layer thickness showed correlation with logMAR visual acuity (r = -0.373, P = 0.016), while other parameters showed no correlation with logMAR visual acuity. Cases were classified as three groups according to the status of IS-OS layer: continuous group (8 cases), discontinuous group (19 cases) and interrupted group (14 cases). LogMAR visual acuity in these eyes with an interrupted IS-OS line in the fovea was significantly worse than that in eyes with a continuous or discontinuous IS-OS line (P = 0.030 and 0.003, respectively). There was no statistical difference between continuous and discontinuous group (P = 0.750). CONCLUSIONS: In patients with persistent cystoid macular edema associated with BRVO, the thickness of the foveal photoreceptor layer are positively associated with visual acuity, and the eyes without IS-OS layer have worse visual acuity than eyes with IS-OS layer.

[Features of vitreomacular traction syndrome assessed with three-dimensional spectral-domain optical coherence tomography].

OBJECTIVE: To describe features of vitreomacular traction syndrome (VMT) on three-dimensional (3D) spectral-domain optical coherence tomography (SD OCT). METHODS: Eighteen eyes of 18 patients with VMT were diagnosed by SD OCT. SD OCT images were obtained and retrospectively analyzed. These VMT cases were defined as focal type or broad type by the region of the vitreous attachment to the macula. The relationship between the logMAR best corrected visual acuity (BCVA) and the retinal thickness of macular fovea was evaluated by linear regression analysis. RESULTS: SD OCT provided detailed 3D images of VMT and revealed information about the extent of vitreomacular traction. Focal VMT was seen in 14 eyes. Broad VMT was seen in four eyes. Eight cases had concurrent epiretinal membrane in the areas surrounding the fovea. Two cases had concurrent full thickness macular hole and two cases had concurrent lamellar macular hole. LogMAR BCVA correlated with the retinal thickness of macular fovea (r = 0.616, P = 0.007, linear regression analysis). CONCLUSIONS: SD OCT allows good visualization of the architectural morphology of the vitreous and retina in vitreomacular traction syndrome. It is useful and irreplaceable for the diagnosis and follow-up of VMT.